Desirable Characteristics in an Orthognathic Surgeon: A National Survey of Orthodontists

Orthognathic surgery is a complex dental, surgical, and orthodontic treatment that requires the expertise of a multi-disciplinary team in order to correct skeletal discrepancies and improve dentofacial esthetics in situations where growth modification or orthodontic camouflage is not possible. The relationship between the orthodontist and the surgeon is of paramount importance and in this cross-sectional study we aim to obtain a better understanding of the characteristics orthodontists value when making referrals for patients requiring orthognathic surgery.

Utilizing the American Academy of Orthodontists Partners in Research Program, an electronic survey of multiple-choice questions was disseminated to participating members in order to collect their opinions regarding their referral process for patients requiring orthognathic surgery. Of the 1,300 orthodontists invited to participate, 174 (13%) accepted the informed consent and responded to the survey. The results were descriptively analyzed. The orthodontists evaluated several characteristics and rated whether they would be more likely to refer, less likely to refer, or indifferent to each characteristic.

A surgeon who understands both pre-surgical and non-surgical orthodontic diagnosis and treatment planning was the most highly valued characteristic when making referrals for orthognathic treatment (94% more likely to refer, 52% most important characteristic). Other characteristics noted include a surgeon that accepts the patient’s medical insurance (64% more likely to refer, 9% most important characteristic), one that leads the surgical treatment planning process (56% more likely to refer, 13% most important characteristic), and having a personal relationship with the surgeon (44% more likely to refer, 9% most important characteristic). The number of cases performed per year, predictable results, and good communication were also important characteristics noted by the participants.

In regards to a surgeon’s educational background, 21% of orthodontists would be more likely to refer to an oral surgeon with a medical degree, while 77% responded that it does not affect their choice. In regards to time out of residency, 52% of orthodontists would be less likely to refer to a surgeon who recently completed residency.

This study highlights the salient role the relationship between the surgeon and orthodontist plays when treating patients with skeletal discrepancies. As orthognathic surgeons, it is important to not only build our medical knowledge of contemporary orthodontic techniques but to also build strong relationships with our referring orthodontists.

References:

1. Funderburk, J. Poster Board Number 90: Evaluation of Importance of Criteria Used by General Denitsts and Orthodontists for Making Referrals to Oral and Maxillofacial surgeons. Journal of Oral and Maxillofacial Surgery, Vol 68, issue 9 Supplement. E112. Sept. 2010.
2. Farrell, Brian, Tucker, Myron. Safe, Efficient, and Cost-Effective Orthoghanthic Surgery in the Outpatient Setting. Journal of Oral and Maxillofacial Surgery Volume 67, Issue 10. P2064-2071, Oct. 2009.